During the COVID-19 global pandemic, a county-based adult behavioral health clinic promptly transitioned from face-to-face patient encounters to telepsychiatry technologies. Due to a low resilience for change and scarcity of quality improvement norms and procedures, identification of staff responsible for patient anticipatory guidance and telepsychiatry education were contacted to engage in an on-demand module on the patient experience of telepsychiatry. A pre-and-post test survey was administered, classifying specific themes for quality improvement via grounded theory. Themes emerged were analyzed through the lens of the quality improvement model, Plan-Do-Study-Act (PDSA), and evidence-based procedures and models via nationally recognized and federal healthcare entities. Implications explored included upstream analysis of quality improvement at the county-based health department and behavioral health clinic, work-burden relative to mismanagement of telepsychiatry, and the necessity for continued quantitative and qualitative data collection on patient experience, attendance of tele-appointments, medication non-adherence, suicidal and homicidal behaviors, and emergency room visits, during the continued implementation of evidence based telepsychiatry.